Cigna dental plans: DPPO, DHMO, DEPO and more

Cigna names five kinds of dental plan, and knowing which one you hold answers most cost questions before you call. The DPPO covers out-of-network care and usually has a deductible and an annual maximum. The DHMO asks for a network general dentist, usually has no deductible and no annual maximum, and pays nothing out of network except emergencies and cases the law requires. Dental indemnity has no network and reimburses up to a usual, customary and reasonable amount. The DEPO needs network dentists but no primary dentist. The DPOS blends the DHMO and DPPO. Cigna's pages say preventive limits, waiting periods and orthodontic terms vary by plan. Before you enroll or book treatment, confirm which of the five plan types you hold, whether your dentist is in Cigna's network for that type, and what preventive limit or waiting period applies to the procedure you need.

Before you book: verify cigna dental plans

1
Look at your plan name to see which design you hold
2
Confirm the deductible, coinsurance and annual maximum in writing
3
Ask whether a waiting period applies to crowns, bridges or orthodontics
4
Search the directory for the network your plan uses
5
Ask if prior dental coverage can waive a waiting period

Five designs

What each Cigna dental plan type means

Factor	Detail
DPPO	A network of dentists, with coverage outside it at higher cost. No primary dentist needed and no specialist referral. Typically an annual deductible, coinsurance and an annual maximum.
DHMO	You choose a network primary dentist who provides routine care and refers you to specialists. Typically no deductible and only a set fee for non-preventive services, and usually no annual maximum.
Dental indemnity	Often called traditional or fee-for-service. No network and no primary dentist. You pay until the deductible is met, then share costs up to a usual, customary and reasonable amount. Cigna says these plans tend to cost a bit more.
DEPO	You must use network dentists. No primary dentist and no specialist referrals. Out-of-network coverage may apply to some emergencies. Usually a deductible and coinsurance.
DPOS	Combines the DHMO and DPPO. You may see outside dentists, but costs are lowest in network, and you choose a primary dentist who provides referrals.

DHMO facts

What Cigna says about its Dental Care DHMO

Factor	Detail
Deductible and maximum	Cigna says its Dental Care DHMO has no deductible before coverage begins and no annual dollar maximum on covered services.
Claims and waiting periods	No claim forms and no waiting periods, according to the same page.
Referrals	Network orthodontists and pediatric dentists for children 13 and under can be seen without a referral. Orthodontics is only covered if your plan includes it.
Out of network	Not covered unless the care is an emergency or the law requires it. Some states mandate more, and Cigna's page names Minnesota and Oklahoma as examples.
Preventive limits	Most plans limit cleanings and bitewing X-rays to two a calendar year, and full-mouth or panoramic X-rays to one every three calendar years.
Availability	Cigna says the plan is not available in all states, and that the word DHMO covers designs that vary by state.

These statements come from Cigna's page for employer-offered plans. Your own plan's Dental Fee Overview is the controlling document.

DPPO facts

What Cigna says about its DPPO

Factor	Detail
Choice	See any licensed dentist or specialist with no primary dentist and no referral. Using an in-network dentist saves money.
How cost sharing works	After you meet the annual deductible and any waiting period, you pay a coinsurance and the plan pays the rest, up to the yearly or lifetime dollar limit.
Preventive limits	Generally two cleanings a calendar year, one bitewing X-ray a calendar year, and one full-mouth and one panoramic X-ray every five calendar years.
Not covered	Cigna gives athletic mouth guards and prescription medications as examples of preventive-related items generally not covered.
Texas	In Texas the insured plan is called Cigna Dental Choice and uses the national DPPO network.

Side by side

How the DHMO and DPPO compare on the questions that cost money

Cigna sums it up as cost against flexibility. A DHMO usually has no deductible, no annual maximum and no waiting period, but it requires a primary dentist and the network. A DPPO lets you go anywhere, at lower cost in network, and usually has a deductible, an annual maximum and often a waiting period. Cigna also says waiting periods are more often a feature of DPPOs, though it depends on the plan, and that many plans waive a waiting period if you can show earlier dental coverage. Preventive care is usually covered in full under both, with age limits and yearly frequency limits.

The Cigna DHMO page says no waiting periods for its employer plan, while its general guide says a waiting period is more common on PPOs. Both can be true. Check your own plan.

Where people get caught

Common surprises with Cigna dental coverage

Not knowing which of the five designs you hold, and expecting DHMO rules from a DPPO or the reverse

Using an out-of-network dentist on a DHMO or DEPO and finding nothing is paid

Reaching a DPPO annual maximum with treatment still unfinished

Assuming preventive care has no limits. Two cleanings a year is a common cap.

Expecting orthodontics to be covered without checking whether your plan includes it, and at what age limit

Questions people ask

Common questions

What is the difference between a Cigna DHMO and a DPPO?

Cigna says the difference is cost and flexibility. A DHMO needs a network primary dentist, usually has no deductible and no annual maximum, and pays only for network care apart from emergencies. A DPPO lets you use any licensed dentist at higher cost outside the network, and usually has a deductible and an annual maximum. Pick by which dentists you want to see.

Does a Cigna DPPO have an annual maximum?

Cigna says most DPPO plans do, and that most DHMO plans do not. The annual maximum is the most the plan will pay for covered services in a plan year. When you reach it you pay the rest. Cigna's DPPO page also refers to a yearly or lifetime dollar limit. Your plan documents give the actual figure.

Does Cigna dental have waiting periods?

Some plans do. Cigna says a waiting period is the time between the plan's effective date and the date you are covered, and that it may differ for basic and major care. Waiting periods are more often found on DPPO plans. Many plans waive it if you had earlier coverage. Its Dental Care DHMO page says no waiting periods for that plan.

What is a Cigna DEPO?

It is a dental exclusive provider organization plan. You must see network dentists to be covered, but you do not need a primary dentist and you do not need referrals to reach specialists. Out-of-network coverage may apply to some dental emergencies. Cigna says these plans usually carry a deductible and coinsurance.

What is dental indemnity?

Cigna calls it a traditional or fee-for-service plan. There is no network, so you can see whichever dentist you want, and you may not need referrals. You pay until you meet the deductible, then you and the plan share costs up to what the plan considers usual, customary and reasonable. Cigna says these plans tend to cost a bit more.

How many cleanings does Cigna cover?

Cigna's pages say most plans limit cleanings to two per calendar year. They also list yearly limits for bitewing X-rays and longer gaps for full-mouth and panoramic X-rays. Age limits can apply too. These are the typical limits Cigna describes, and your plan documents list the ones that bind you.

Can I see an out-of-network dentist on a Cigna DHMO?

Generally no. Cigna says most DHMOs only cover out-of-network services in an emergency or where the law requires it. Some states require more, and Cigna's page names Minnesota and Oklahoma as examples. If you want freedom to leave the network, a DPPO or DPOS is the design that allows it.

Does Cigna dental cover orthodontics?

Only if your plan includes it. Cigna's pages say to check age limits, plan limits, and whether your orthodontist is in the network. On the DHMO, network orthodontists can be seen without a referral if orthodontic coverage is part of the plan. Cigna also lists some orthodontic services that are generally not covered.

Which Cigna network do I use?

The one your plan names. Cigna's DPPO and DHMO pages each point to a provider directory on Cigna's site. The DHMO and DPPO use different networks, so a dentist listed for one may not be listed for the other. Search the directory under your own plan and confirm with the office.

Can a previous dental plan shorten my waiting period?

Sometimes. Cigna says many plans waive the waiting period if you can show you were enrolled in a dental plan just before the new one. Ask the plan what proof it accepts and by when. If the waiver is refused, ask which services are affected, because a filling may be covered sooner than a crown or bridge.

Which Cigna plan types have no primary dentist?

Cigna says the DPPO, the dental indemnity plan and the DEPO do not require a primary dentist. The DHMO and the DPOS do. On a DPPO and an indemnity plan you also need no referrals to see specialists. Check which design your plan is before you assume, since Cigna says designs vary by state.

Where do I find a Cigna network dentist?

Cigna's DPPO and DHMO pages each point to a provider directory on Cigna.com, and the two use different networks. Search under your own plan, then confirm the office takes your specific plan. Cigna says that in Texas the insured plan is called Cigna Dental Choice and uses the national DPPO network.